State of confusion over healthcare reform

This weekend was the third anniversary of the federal healthcare reform law--and pundits and politicos marked it with cheers and jeers.

U.S. Department of Health & Human Services Secretary Kathleen Sebelius touted cost savings and jobs creation, for example, tellingUSA Today that Republican governors will ultimately fall into line with public opinion and embrace Medicaid expansion.

Eight Republication governors say they'll support Medicaid expansion in their states--and another five are considering it. But that leaves 17 who are standing firm against it, the article notes.

And it's not as though governors have the last word. Florida Gov. Rick Scott said he would support the reform law's Medicaid expansion--but his change of heart was stymied when a Republican-led Senate committee rejected his plan.

Meanwhile, some states are saying they can't or won't enforce the healthcare reform law, deferring instead to HHS to guarantee insurers in their state comply with the provisions, FierceHealthPayer reported last week.

Florida, for example, won't penalize insurers for violating new consumer protections but will report those insurers to HHS to take further action. Other state officials say their legislatures haven't granted them the authority to oversee reform requirements. In Wyoming, the state insurance department said it lacks regulatory authority for the reform law.

Meanwhile, the House celebrated the anniversary by voting--once again--to repeal healthcare reform. That vote won't pass the Democrat-controlled Senate, but the Senate did cast its own symbolic vote to repeal the 2.3 percent tax on medical device sales, a part of the ACA that's designed to offset costs (Unlikely, notesThe Wall Street Journal).